| NPI | 1851383053 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207NS0135X Dermatology, Procedural Dermatology (Licence: FL ME20801) |
| Additional Taxonomies | 207N00000X Dermatology (Licence: FL ME20801) |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2011-12-07 |